Provider Demographics
NPI:1629139928
Name:VARGHESE, FLORA POIKAYIL (MD)
Entity Type:Individual
Prefix:MS
First Name:FLORA
Middle Name:POIKAYIL
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:481 PLUMAS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-5075
Mailing Address - Country:US
Mailing Address - Phone:530-749-2409
Mailing Address - Fax:530-751-4793
Practice Address - Street 1:481 PLUMAS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5075
Practice Address - Country:US
Practice Address - Phone:530-749-2409
Practice Address - Fax:530-751-4793
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149629208600000X
TXM6930208600000X
TXBP10024434208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery